Kanda T, Sasaki-Tanaka R, Kamimura H, Terai S. Is higher body mass index correlated with worse clinical outcomes in acute liver failure? World J Clin Cases 2025; 13(32): 113514 [DOI: 10.12998/wjcc.v13.i32.113514]
Corresponding Author of This Article
Tatsuo Kanda, MD, PhD, Professor, Division of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minamiuonuma 949-7302, Niigata, Japan. kandatatsuo@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 16, 2025 (publication date) through Nov 15, 2025
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Kanda T, Sasaki-Tanaka R, Kamimura H, Terai S. Is higher body mass index correlated with worse clinical outcomes in acute liver failure? World J Clin Cases 2025; 13(32): 113514 [DOI: 10.12998/wjcc.v13.i32.113514]
Tatsuo Kanda, Division of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minamiuonuma 949-7302, Niigata, Japan
Tatsuo Kanda, Department of General Medicine, Uonuma Kikan Hospital, Minamiuonuma 949-7302, Niigata, Japan
Reina Sasaki-Tanaka, Hiroteru Kamimura, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8520, Niigata, Japan
Author contributions: Kanda T wrote the original draft; Kanda T, Sasaki-Tanaka R, Kamimura H, and Terai S designed the overall concept and outline of the manuscript and wrote the paper; Kanda T contributed critical revision of the manuscript for important intellectual content. All the authors have read and approved the final version of the manuscript.
Supported by the Japan Agency for Medical Research and Development, No. JP24fk0210132 and No. JP25fk0210132; and JSPS KAKENHI, No. JP23K15055.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tatsuo Kanda, MD, PhD, Professor, Division of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minamiuonuma 949-7302, Niigata, Japan. kandatatsuo@gmail.com
Received: August 27, 2025 Revised: September 2, 2025 Accepted: September 26, 2025 Published online: November 16, 2025 Processing time: 77 Days and 7.4 Hours
Abstract
Krishnan et al’s article is a comprehensive and vigorous retrospective cohort study regarding the association between obesity and clinical outcomes in acute liver failure (ALF). Among patients with ALF in the United States, mean body mass index (BMI) was significantly greater in those who underwent liver transplantation or who died than among survivors, although acetaminophen induced ALF was the most common etiology. A high BMI was associated with renal failure and high grades of hepatic encephalopathy. The prevalence of obesity and its related fatty liver diseases, such as metabolic dysfunction-associated fatty liver disease/ metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis, has increased worldwide. Obesity is related to increased serum cytokines and immune abnormalities. These findings may explain why ALF in patients with high BMI is associated with worse clinical outcomes. Further studies are needed to determine the associations among BMI, ALF and acute-on-chronic liver failure.
Core Tip: Association between obesity and clinical outcomes in acute liver failure (ALF) was recently shown by Krishnan et al. Kaplan-Meier analysis revealed a significant difference in mortality between overweight and obese patients and patients with normal body mass index (BMI). Overweight and obese patients with ALF had a 2.20-fold and 2.04-fold increased risk of liver transplantation/death, respectively. A higher BMI was associated with acute kidney injury and higher grades of hepatic encephalopathy. Further studies are needed to determine the distribution of BMI among patients with acute severe hepatitis, including ALF and acute-on-chronic liver failure.
